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YALE MEDICAL LIBRARY 



HISTORICAL LIBRARY 



The Bequest of CLEMENTS COLLARD FRY 



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TREATISE 



HYSTEKIA. 



TEEATISE 



ON 



HYSTERIA. 



BY 



ROBERT LEE, M.D., F.R.S. 

LATE PHYSICIAN TO Tint BRITISH LYINO-IN HOSPITAL, AND ST. MAHY-LE-BONB INFIBMAnY; 

OBSTETKIC PHYSICIAN TO ST. GEORGE'S TIOSPITAL; AND REGIUS PROFESSOR OF 

MIDWIFBBT IN THE UNIVERSITY OF GLASGOW. 




LONDON: 
J. and A. CHURCHILL, NEW BURLINGTON STREET. 

1871. 




OCT 1961 









LONDON : 

SAYILL, EDWARDS AND CO., PRINTERS, CHANDOS STREET, 

COVENT GARDEN. 



A TEEATISE ON HYSTEEIA. 



One of the most rare and characteristic symptoms 
of hysteric diseases {irrapnog, sternutatio) has been 
mentioned by Hippocrates in his xxxv. Aphorism, 
from which it may be inferred that all the varie- 
ties of these diseases had long been well known 
to the Greeks. 

Aretseus has thus described hysteric diseases in 
the eleventh chapter of his works : — "In the middle 
of the flanks of a woman lies the womb, a female 
viscus closely resembling an animal, for it is 
moved of itself hither and thither in the flanks, 
also upwards in a direct line to below the carti- 
lage of the thorax, and also obliquely to the right 
or left, either to the liver or spleen ; and it is 
likewise subject to prolapsus downwards — in a 
word, it is altogether erratic ; it delights also in 
fragrant smells, and advances towards them ; and 
it has an aversion to foetid smells, and flees from 
them, and on the whole it is like an animal 
within an animal." 

Where therefore it is suddenly carried and 
remains above for a considerable time, and vio- 
lently compresses the intestines, the woman ex- 



6 A TREATISE ON HYSTERIA. 

periences a choking, after the form of epilepsy, 
but without convulsions; for the liver, dia- 
phragm, lungs, and heart, are quickly squeezed 
within a narrow space, and therefore loss of 
breathing and speech seems to be present ; and 
moreover the carotids are compressed from sym- 
pathy with the heart, and hence there is heavi- 
ness of head, loss of sensibility, and deep sleep. 

Aretseus further observes, that in women there 
also arises another affection resembling this form, 
with sense of choking and loss of speech, but not 
proceeding from the womb, for it also happens 
to men in the manner of catochus ; but those 
from the uterus are removed by foetid smells, and 
the application of fragrant things to the female 
parts ; but in the others these things do no 
good ; and the limbs are moved about in the 
affections from the womb, but in the other affec- 
tion not at all. 

Aretaeus then describes the symptoms which 
he supposed to depend upon the womb's being 
moved upwards, which he says are " sluggishness 
in the performances of her offices, prostration of 
strength, atony, loss of some of her faculties, 
vertigo, and the limbs sink under her, headache, 
heaviness of the head, and the woman is pained 
in the veins on each side of the head. But if 
the womb fall down, women have heartburn in 
the hypochondriac regions ; the flanks are empty, 
pulse intermittent, irregular, and failing, strong 
sense of choking, loss of speech and sensibility, 



A TREATISE ON HYSTERIA. 7 

respiration imperceptible and indistinct, a very 
sudden incredible death, for they have nothing 
deadly in their appearance — a colour like that of 
life, and for a considerable time after death they 
are more ruddy than usual. Eyes somewhat 
prominent, bright, and not entirely fixed, but 
yet not very much turned aside." — (Adams' 
Translation.) 

The characteristic symptoms of hysteria were 
known to Galen, Celsus, and other subsequent 
writers. 

An epistle from Dr. Thomas Sydenham to 
Dr. William Cole, treating of the small-pox and 
hysteric diseases, was published January 20th, 
1681-2. 

" I proceed now," he says, " in compliance 
with your request, to communicate the observa- 
tions I have hitherto made concerning hysteric 
disorders, which I own are not so easily dis- 
covered nor so readily curable as other diseases. 
However, I will endeavour to acquit myself herein 
to the best of my ability, and with that brevity 
which a letter requires, which in reality I am 
obliged to on account of my ill-health, particu- 
larly at this season of the year, when too intense 
application would immediately bring on a fit of 
the gout. For this reason I shall avoid prolixity, 
and proceed according to my usual method, 
which consists in giving a short history of the 
disease according to its genuine natural pheno- 
mena, and subjoining the method of cure which 



8 A TREATISE ON HYSTERIA. 

hath succeeded best with me, and which I for- 
merly learnt rather from my own experience than 
from reading." 

" Hysteric diseases," says Sydenham, " make 
a moiety of chronic diseases ; these appear under 
numerous forms, resembling most of the dis- 
tempers wherewith mankind are afflicted. The 
hysteric passion sometimes resembles an apoplexy 
or epilepsy — sometimes a vehement pain in the 
head, with excessive vomiting — sometimes it 
causes a palpitation of the heart — sometimes a 
dry cough — sometimes a disorder resembling the 
iliac passion — sometimes a disorder resembling a 
fit of the stone — sometimes it occasions a con- 
tinual vomiting or purging — sometimes it attacks 
the external parts, causing a pain or tumour of 
the fauces, shoulders, hands, thighs, and in 
which kind the swelling which distends the legs 
is most remarkable. For whereas in dropsical 
swellings these two particulars may always be 
observed — namely, they increase towards night, 
and pit for some time, being pressed by the finger ; 
in this tumour the swelling is largest in the 
morning and does not yield to the finger or leave 
any mark behind it, and it generally swells only 
one of the legs." 

The teeth also (which one would scarce believe 
are subject to this disease), though free from the 
least cavity and manifest defluxion that might 
cause pain, which nevertheless is not at all milder, 
of shorter continuance, or more easily curable. 



A TREATISE ON HYSTERIA. 9 

But the pains and swellings that affect the ex- 
ternal parts chiefly happen to such women as 
are almost worn out by the long continuance 
and violence of hysteric fits. 

But the most frequent of all the tormenting 
symptoms of this disease is a pain of the back, 
which generally accompanies even the slightest 
degree of it. The above-mentioned pains like- 
wise have this effect — that the part they affect 
cannot bear the touch after they are gone off, but 
remains tender and painful as if it had been se- 
verely beaten ; but this tenderness wears off by 
degrees. 

"It is likewise extremely well worthy noting 
that all these symptoms are preceded by a re- 
markable coldness of the external parts, which 
seldom goes off before the fit ceases. And I 
have observed that this coldness resembles that 
which is perceived in dead bodies, the pulse not- 
withstanding continuing regular. Whereto may 
be added, that most of the hysteric women that 
I have hitherto treated have complained of a 
lowness and a sinking of the spirits by their 
pointing to the region of the lungs, to show the 
part affected seemed to be seated there. Lastly, 
it is generally known that hysterical women 
sometimes laugh and sometimes cry excessively 
without the least apparent provocation." 

But amongst the symptoms accompanying this 
disease, the most peculiar and general one is 
the making great quantities of water ; which I 



10 A TREATISE ON HYSTERIA. 

find upon diligent inquiry to be the distinguish- 
ing sign of those disorders which we call hypo- 
chondriac in men, and hysteric in women. 

" Moreover, in hysteric and hypochondriac sub- 
jects, when the disease has been of long stand- 
ing, they have foetid and sometimes highly acid 
eructations after eating, though they eat mode- 
rately according to the appetite, the digestive 
faculty being greatly impaired, and the juices 
vitiated." 

" It would take up too much time to enume- 
rate all the symptoms belonging to hysteric dis- 
eases, so much do they vary and differ from each 
other. Democritus, therefore, in writing to Hip- 
pocrates, seems to have had reason to assert, 
though he mistook the cause of the disease, that 
the womb was the origin of six hundred evils 
and innumerable calamities Nor do they only 
differ so greatly, but are so irregular likewise, that 
they cannot be comprehended under any uniform 
appearance as is usual in other diseases ; but are 
a kind of disorderly train of symptoms, so that it 
is difficult to write the history of this disease." 

Sydenham referred this disorderly train of 
symptoms, which he said almost defied descrip- 
tion, " to irregular motion of the spirits," " dis- 
order of the animal spirits." To this irregular 
motion of the spirits the clavus hystericus is to 
be ascribed, in which all the spirits are collected 
in a certain point of the pericranium, occasioning 
such a kind of pain as if a nail were driven into 



A TREATISE ON HYSTERIA. 11 

the head, and attended with a copious discharge 
of green matter by vomit. And this contraction 
of all the spirits into a kind of point differs little 
from a collection of the rays of the sun by a 
burning glass, for as these burn by their united 
force, so those for the same reason cause a pain 
by tearing the membranes with united violence. 

The chief curative indication in this disease, 
according to Sydenham, is that which directs 
strengthening of the blood, which is the source and 
origin of the spirits. Bleeding, purging, opiates, 
foetid medicines, chalybeates, Venice treacle, 
bitters, bark, milk diet, were some of the means 
which he employed to strengthen the blood, and 
subdue the irregular actions and motions of the 
animal spirits. But the best thing I have 
hitherto found for strengthening and clearing 
the spirits, is riding on horseback some hours 
almost every day. 

Sydenham published no cases of hysteria in 
women, and the two following are the only cases 
he published which he considered genuine exam- 
ples of hysteria in the male sex : — 

" Three years since a nobleman sent for me, 
who seemed to be afflicted with a hypochondriac 
colic, differing little from an iliac passion, at- 
tended with pain and immoderate vomitings, 
which he had long laboured under, so that he 
was in a manner worn out. During the whole 
course of the disease, whenever he was worse I 
observed that he always voided a clear colourless 



12 A TREATISE ON HYSTERIA. 

urine; but upon the abatement of the disorder 
it inclined to its natural straw colour. Visiting 
him one day, I found that his urine was made at 
several times, and kept apart, of a straw colour, 
and he was very cheerful, had an appetite, and 
thought of eating something of easy digestion ; 
but some person coming in that instant, and 
putting him into a violent passion, he imme- 
diately thereupon made a large quantity of clear 
water." 

Sydenham has recorded, in the following his- 
tory, his second case of supposed hysteria in the 
male sex, and which has been quoted as such by 
many subsequent authors, without sufficient 
evidence : — 

" I was called, not long since, to an ingenious 
gentleman, who had recovered of a fen fever but 
a few days before. He employed another phy- 
sician, who had blooded and purged him thrice, 
and forbade him the use of flesh. When I came 
and found him up, and heard him talk sensibly on 
some subjects, I asked him why I was sent for ; 
to which one of his friends replied — ' If I would 
have a little patience, I should be satisfied.' 
Accordingly, sitting down and entering into 
conversation with the patient, I immediately 
perceived that his under lip was thrust outward, 
and in frequent motion (as it happens to fretful 
children before they cry), which was succeeded 
by the most violent fit of crying I had ever seen, 
attended with deep and almost convulsive sighs ; 



A TREATISE ON HYSTERIA. 13 

but it soon went off. I conceive that this dis- 
order proceeded from an irregular motion of the 
spirits, occasioned by the long continuance of 
the disease, but partly by the evacuations that 
were required in order to the cure." 

The difference between hypochondriac and 
hysteric diseases has thus been described by 
Dr. Hoffman : — " The hysteric passion is falsely 
held by several modern writers to be the same 
with the hypochondriac disease, or to differ only 
with respect to the sex and not in nature ; the 
latter seizing only men and the former women. 
But to show that there is a real difference between 
them it would be worth while to give a true his- 
tory of the hysteric disease, to which end if we 
consult the ancients, and especially Hippocrates, 
Aretseus, Fernelius,Donatus, Montanus, Ballonius, 
Mercuriales, and J. Heinsius, they seem unani- 
mously of opinion that a strangulation of the 
fauces, quick and difficult respiration, so as to en- 
danger suffocation, loss of speech, and all sense 
of motion, are to be accounted the proper and 
essential symptoms of this uterine disease; and, in 
effect, though both the hypochondriac and hysteric 
diseases appear to have some symptoms in com- 
mon, yet they have several ones respectively 
which fully manifest that they differ considerably 
from each other." — Note, p. 368. 

The first lines of the " Practice of Physic," 
and the " Synopsis Nosologise Methodicse," of 
Dr. Cullen, contain an elaborate description of 



14 A TREATISE ON HYSTERIA. 

the phenomena of hysteria, and a hypothesis 
slightly different from that of Sydenham is pro- 
pounded to explain all the symptoms, which it 
does not accomplish in a satisfactory manner. 
At page 285 he says : — " Having thus endea- 
voured to distinguish hysteria from every other 
disease, I shall now attempt its peculiar patho- 
logy. With respect to this it will, in the first 
place, be obvious that its paroxysms begin by a 
convulsive spasmodic affection of the alimentary 
canal, which is afterwards communicated to the 
brain, and to a great part of the nervous system . 
Although the disease appears to begin in the ali- 
mentary canal, yet the connexion which the 
paroxysms so often have with the menstrual 
flux, and with the diseases that depend on the 
state of the genitals, shows that the physicians 
have at all times judged rightly in considering 
this disease as an affection of the uterus and other 
parts of the genital system. 

" With regard to this, however, I can go no 
further. In what manner the uterus, and in 
particular the ovaria, are affected in this disease, 
how the affection of these is communicated with 
particular circumstances to the alimentary canal, 
or how the affection of this rising upwards affects 
the brain so as to occasion the convulsions which 
occur in this disease, I cannot pretend to explain. 

" But although I cannot trace this disease to 
its first causes, or explain the whole of the phe- 
nomena, I hope that with respect to the general 



A TREATISE ON HYSTERIA. 15 

nature of the disease, I may form some general 
conclusions which may serve to direct our conduct 
in the cure of it. 

" Thus from a consideration of the predis- 
ponent and occasional causes it will, I think, 
appear that the chief part of the proximate 
cause is a mobility of the nervous system de- 
pending generally on its plethoric state. 

" TVhether this disease ever arises from a 
mobility of the system, independently of any 
plethoric state of it, I cannot possibly determine ; 
but in many cases that have subsisted for some 
time it is evident thatasensibilityandconsequently 
a mobility are acquired which often appears when 
neither a general plethora can be supposed to 
subsist nor an occasional turgescence to have 
happened. However, as we have shown above 
that a distension of the vessels of the brain seems 
to accompany epilepsy, and that a turgescence of 
blood in the vessels of the lungs seems to produce 
asthma ; so analogy leads me to suppose that a 
turgescence of blood in the uterus, or in other 
parts of the genital system, may occasion the 
spasmodic convulsions which appear in hysteria. 
It will, at the same time, be evident that this 
affection of the genitals must especially occur in 
plethoric habits, and every circumstance men- 
tioned in the history of this disease seems to 
confirm this opinion with respect to its proxi- 
mate cause." 

In 1806 a treatise on the utility and adminis- 



16 A TREATISE ON HYSTERIA. 

tration of purgative medicines in hysteria and 
several other diseases, was published by Dr. 
James Hamilton, Physician to the Eoyal Infir- 
mary of Edinburgh. After describing the com- 
mon symptoms of hysteria, Dr. Hamilton says t 
" Frequent disappointments in curing hysteria 
have led me to take a full and, I hope, an impar- 
tial review of the subject. This review has 
inclined me to doubt the solidity of the opinions 
which have been entertained respecting hysteria, 
and the soundness of that uniform practice 
which has been so long followed in the treatment 
of it." 

After stating the opinions of Sydenham, the 
author observes : — " To have quoted these pas- 
sages setting forth the opinions of Sydenham's 
doctrine on this subject, is pace tanti viri to 
refute it. For, indeed, it is not easy to compre- 
hend what Sydenham understands by the animal 
spirits, or in what manner they are impelled by 
rapid motion from one place or organ into an- 
other, so as to induce precisely the hysterical 
convulsion." 

Eespecting Dr. Cullen's theory, Dr. Hamilton 
considered that it rested more upon supposition, 
and a consequent train of reasoning, than upon 
facts and experience ; and that it therefore now 
meets less attention than it has commanded for 
many years. " I do not perceive," adds Dr. 
Hamilton, " that Dr. Cullen anywhere mentions 
purgative medicines as proper in hysteria ; Syden- 



A TREATISE ON HYSTERIA. 17 

ham gives them previous to the exhibition of 
other medicines, for three or four consecutive 
mornings. 

"For the rest, both these learned and celebrated 
men treat hysteria with astringent, stimulant, and 
tonic medicines, in the view of restraining and 
regulating the irregular motion of the animal 
spirits, or of obviating the too great sensibility 
and mobility of the system ; the cure of hystei'ia 
by this management is often difficult and gene- 
rally tedious." 

From this history the reader will perceive that 
considerable derangement of the stomach and 
alimentary canal is prevalent throughout the 
whole of this disease. Among the symptoms 
which mark the hysteric constitution, shifting 
pains of the abdomen, flatulence, constipation at 
one time, at another vomiting and purging, to- 
gether with acid and foetid eructations, are con- 
spicuous. 

The sensation of a ball wandering through the 
abdomen and ascending to the stomach, and from 
thence through the oesophagus to the pharynx, is 
a prominent symptom among those which im- 
mediately precede and give warning of the 
approach of the fit. 

Convulsive motions of the muscles of the ab- 
domen, which are thereby greatly contracted and 
drawn inwards, accompany the paroxysm ; upon 
the cessation of which a murmuring noise through- 
out the abdomen is frequently heard. 



IS A TREATISE ON HYSTERIA. 

These symptoms undoubtedly must denote a 
preternatural affection of the stomach and ali- 
mentary canal. In my opinion they afford con- 
clusive evidence that this affection is primary, 
and that the other multifarious symptoms of 
hysteria depend upon it. I have therefore 
thought it reasonable to attend particularly to 
the state of the stomach and intestines, and to 
employ in the first place purgative medicines to 
remove the constipation of the body, which most 
commonly prevails in hysteria. I have seldom 
seen vomiting and purging in cases of pure 
hysteria ; but the presence of these symptoms 
would not deter me from exhibiting purgatives, 
which I should conceive to be peculiarly adapted 
for their removal, as the efficacy of purgative 
medicines in removing these symptoms in other 
circumstances of disease is well known. I was 
the more disposed to adopt this practice in 
hysteria from my experience of its general safety 
and peculiar utility in other diseases that are 
commonly supposed to be of a nervous nature. 

In particular cases, where great anxiety pre- 
vails, recourse may be had to wine in moderate 
quantity, till such time as relief is obtained by 
purgatives. 

I may add by way of caution, that in hysteria, 
as well as in chorea, chlorosis, and haematemesis, 
the full exhibition of active purgatives is neces- 
sary to procure even moderate evacuations from 
the bowels, and that this exhibition must be 



A TREATISE ON HYSTERIA. 19 

continued from day to day till such time as the 
faeces are natural or till the disease ceases. 

Dr. Hamilton believed, as Sydenham did, that 
hysteria occurs in the male sex, and that the dis- 
ease does not originate in the ovaria as Cullen 
suspected, nor in the uterus, as the ancients 
affirmed. 

During the years 1 816 and 1817, when holding 
the office of physician's clerk to Dr. Hamilton, 
in the wards of the Edinburgh Koyal Infirmary, 
extensive opportunities were afforded me of wit- 
nessing the successful results of the treatment of 
hysterical diseases by purgative medicines, mild 
tonics, and light diet. Subsequent observations 
made in London on a great scale, in public insti- 
tutions and in private practice, have led me to 
the conviction that purgative medicines admi- 
nistered in the persevering manner pointed out by 
Dr. Hamilton, are the most powerful remedies 
which can be employed in the treatment of all 
the varied forms of hysterical diseases. 

In 1827 Sir Benjamin Brodie published three 
" Lectures illustrative of certain local Nervous 
Affections." " It was not his object," he said, 
" to give a complete history of any one disease, 
but to pourtray a certain order of symptoms, 
which while they have many characters in com- 
mon, may arise from various causes, and require 
very different modes of treatment for their re- 
lief." A middle-aged lady, subject to fits con- 
nected with hysteria, complained of a constant 



20 A TREATISE ON HYSTERIA. 

severe pain, which she referred to a spot, ahout 
three or four inches in diameter, in the situation 
of the false ribs of the left side. " No morbid 
appearance could be detected in this part after 
death : there was neither inflammation nor adhe- 
sion, nor any morbid change of structure, nor the 
slightest deviation of any kind from the natural 
condition of the part." Now such a case as this 
is by no means uncommon. It is only one of 
many which might be adduced in proof of this 
proposition — namely, that the natural sensations 
of a part may be increased, diminished, or other- 
wise perverted, although no disease exists in it 
which our senses are able to detect, either before 
or after death." 

After adducing various examples of what Sir 
Benjamin considered local hysterical affections in 
the joints, spine, bladder, abdominal viscera, 
oesophagus, larynx, mammae, and other organs of 
the body, as Sydenham had done, in which there 
was no disease discovered after death, he says — 
" I have hitherto described these cases as if 
they were peculiar to the female sex, but it is 
not so in reality ; and I have known several 
(though by comparison rare instances) of males 
being affected in the same manner. I employ 
the term hysteria because it is in common use, 
and because it would be inconvenient to change 
it for another ; but the etymology of it is un- 
doubtedly calculated to lead to a great misappre- 
hension with respect to the pathology of the 



A TREATISE ON HYSTERIA. 21 

disease. It belongs not to the uterus, but to 
the nervous system ; and tbere is no one much 
engaged in medical or surgical practice who will 
not be able to bear testimony to the accuracy of 
Sydenham's observations on this subject : — 
' Quinimo non pauci ex iis viris qui vitam de- 
gentes solitariam chartis solent impallescere 
eodem morbo tentantur.' " 

Having never seen at any period of my life a 
genuine case of hysteria in the male sex, I am 
unable to bear testimony to the accuracy of 
Sydenham's observations on this subject. But 
in tbe female sex I have seen a great number. 
Accurate clinical reports have been made of more 
than two hundred cases, of which written his- 
tories have been preserved. If these be examined, 
it will be seen that in none did the disease occur 
before the age of puberty, and in few after the 
middle period of life. In few of the cases recorded 
were the functions of the ovaria and uterus in a 
perfectly healthy state. In the greater number 
there was amenorrhcea, dysmenorrhoea, menor- 
rhagia, leucorrhcea, or some morbid state of in- 
creased or diminished sensibility of the uterus, 
without any organic disease. In the greater 
number of the cases included in this Clinical 
Report there was incurable sterility. 

In hysteric diseases, the whole nervous system 
appears to suffer in a peculiar manner — the brain, 
spinal cord, all the nerves of sensation and volun- 
tary motion, and especially the ganglia and 



22 A TREATISE ON HYSTERIA. 

other nervous structures of the thoracic, abdo- 
minal, and pelvic viscera. In many cases the 
principal and primary seats of these diseases 
appeared to be the visceral ganglia and nerves, 
especially the uterine and renal. 

The following is a brief analysis of the prin- 
cipal symptoms observed in these cases. Pain 
in the uterine and lumbar regions, in the hips, 
thighs, and abdomen, in the back, neck, temples, 
and various joints ; derangement of the func- 
tions of the uterine organs, irregularity or absence 
of the catamenia, leucorrhcea, discharges of fleshy 
or membranous substances from the uterus and 
vagina; disorder of the stomach and bowels, 
loss of appetite, desire for unnatural and un- 
wholesome food, nausea, vomiting, constipation, 
derangement of the organs of respiration and 
speech, hoarseness or loss of voice, and shortness 
of breath ; cough, difficulty of swallowing, sen- 
sation of fulness in the throat, rigidity of the 
muscles of mastication, complete fixity of the 
jaw, palpitation of the heart, irregular action of 
the kidneys, secretion of urine deficient, or pale 
and abundant ; unhealthy colour of the skin, 
pallor, chlorosis, irritation of the bladder, mictu- 
rition painful and frequent, involuntary retention 
of urine, unnatural tenderness of the abdomen 
and other parts of the body, sensation of crawling 
in the skin or internal organs of the body, swell- 
ing of the abdomen, flatulence, globus hystericus, 
debility, sensation of heat, weight and throbbing 



A TREATISE ON HYSTERIA. 23 

in the head and temples, impairment, indistinct- 
ness of vision, attacks of giddiness, faintness, 
insensibility, paroxysms of laughter and crying, 
melancholy, despair, powers of memory and mind 
impaired, maniacal attacks at the monthly periods 
more especially, disturbed sleep, dreams, loss of 
power in the arms or legs, coldness or tingling, 
swelling of the ankles. 

^Respecting the origin of hysteria, I have been 
led to believe, from the symptoms observed in 
these two hundred cases, and from facts which 
have been ascertained during the present cen- 
tury respecting the structure and physiology 
of the ovaria and Graafian vesicles and the cause 
of menstruation, that hysteria originates in the 
ovaria. It is now known that all the peculi- 
arities of the female sex depend upon the ovaria, 
and at the age of puberty the Graafian vesicles 
contain mature ova, which are ready to escape 
at the monthly periods, and that upon this pro- 
cess all the phenomena of menstruation dejiend. 

Between the ovarian and uterine ganglia and 
nerves and the brain there is an intimate con- 
nexion established through the visceral ganglia 
and nerves of the thorax, abdomen, and pelvis. 

From the symptoms observed in different 
cases of hysteria, I have been induced to think 
that the uterine ganglia and nerves have often 
been the chief seats of the disease ; in others the 
semilunar ganglia of the great sympathetic ; 
and in others, the great ganglia on the trunks 



24 A TREATISE ON HYSTERIA. 

of the par vagum at the root of the heart and 
lungs, from which the recurrent nerves pro- 
ceed to the larynx, trachea, and other parts con- 
nected with respiration and deglutition. 

The symptoms in many cases of hysteria 
clearly point out the renal ganglia and nerves 
which supply the ovaria as the nervous struc- 
tures chiefly affected. 

If the cases contained in this Clinical Report 
be carefully examined, it will appear that in 
their treatment, cathartic medicines, mild vege- 
table tonics, light diet, exercise in the open air 
near the sea-shore, on foot or on horseback, 
tepid bathing and tepid hip-baths, and the 
proper regulation of the mind, were the most 
useful remedies, and that under this treatment 
the greater number were in the course of time 
restored to health. 

Other methods of treatment had been had 
recourse to in many of these cases by other 
practitioners of reputation without any tem- 
porary or permanent benefit. 

The following is a simple enumeration of 
these : — 

Assafcetida, valerian, and ammonia. 

Ammoniated tincture of guaiac. 

Bromide and iodide of potassium. 

Balls of mercury introduced into the vagina. 

Sulphate of zinc and sulphate of copper. 

Chloroform. 

Bichloride of mercury and quinine. 



A TREATISE ON HYSTERIA. ZO 

Extract of aconite and camphor. 

Tincture of sumbul. 

Tincture of castor. 

Cubebs and taraxacum. 

Liquor potassae. 

Acetic acid. 

Strychnine and iron. 

Leeches to the os uteri. 

Dilating the os uteri with bougies. 

Cutting the os and cervix uteri with hystero- 
tomes and other cutting instruments. 

Long-continued courses of speculum and 
caustic treatment. 

Mesmerism, galvanism, and galvanic chains. 

Homoeopathy and hydropathy. 

Cold and warm bathing. 

Various mineral waters, especially those of 
Spa, Kreutznach, Homburg, and Kissingen. 

Clitoridectomy ; and, lastly, 

Cutting away the coccyx. 



ENGRAVINGS 



GANGLIA AND NERVES 



UTERUS AND HEART. 

{From the " Philosophical Transactions") 



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No. 3 



\. 



London, 7, Great Marlborough Street, 
May, 1897. 



A SELECTION 

FROM 

J. & A. CHURCHILL'S CATALOGUE, 

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MOST OF THE RECENT WORKS PUBLISHED BY THEM. 



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CHURCHILL'S LIST. 



Allen's Chemistry of Urine, 12 

Commercial Organic Analysis, 13 

Anderson's Deformities of Fingers and Toes, 9 
Armatage's Veterinary Pocket Remembrancer, 14 
Barnes (R.) on Obstetric Operations, 3 

on Diseases of Women, 3 

Beale (L. S.) on Liver, 6 

Microscope in Medicine, 6 

Slight Ailments, 6 

Urinary and Renal Derangements, 12 

Beale (P. T. B.) on Elementary Biology, 2 
Beasley's Book of Prescriptions, 5 

Druggi.-ts' General Receipt Book, 5 

Pocket Formulary, 5 

Bell on Sterility, 3 

Bellamy's Surgical Anatomy ; 1 

Bentley and Trimen's Medicinal Plants, 5 

Bentley's Systematic Botany, 5 

Berkart's Bronchial Asthma, 6 

Bernard on Stammering, 7 

Bernays' Notes on Analytical Chemistry, j 
Bigg's Short Manual of Orthopaedy, 9 
Bloxam's Chemistry, 12 

Laboratory Teaching, 12 

Bousfield's Photo-Micrography, 14 
Bowlby's Injuries and Diseases of Nerves, 9 

Surgical Pathology and Morbid Anatomy 9 

Brockbank on Gallstones, 8 

Brodhurst's Anchylosis, 9 

Curvatures, &c, of the Spine, 9 

Talipes Equino- Varus, 9 

Dislocation of Hip, 9 

Brown's Practical Chemistry, 13 
Bryant's Practice of Surgery, 8 

Burckhardt's (E.) and Fenwick's (E. H.) Atlas of 

Cystoscopy, 11 
Burden's Hospitals and Asylums of the World, * 
Butler-Smythe's Ovariotomies, 4 
Butlin's Malignant Disease of the Larynx, ir 
Operative Surgery of Malignant Disease, ti 

Sarcoma and Carcinoma, 11 

Buzzard's Diseases of the Nervous System, 7 
Peripheral Neuritis, 7 

Simulation of Hysteria, 7 

Cameron'= Oils, Resins, and Varnishes, 14 

SoLps and Candles, 14 

Carpenter and Dallinger on the Microscope, 14 
Carpentei's Human Physiology, 2 
Cautley's Infant Feeding, 4 
Charteris on Health Resorts, 8 

Practice of Medicine, 6 

Chauveau's Comparative Anatomy, 14 
Chevers' Diseases of India, 5 
Churchill's Face and Foot Deformities, 9 
Clarke's Eyestrain, 10 

Clouston's Lectures on Mental Diseases, 3 
Clowes and Coleman's Quantitative Analysis, 13 

. Elmntry Practical Chemistry, 13 

Clowes' Practical Chemistry, 13 

Cooley's Cyclopaedia of Practical Receipts, 13 

Cooper on Syphilis, 12 

Cooper and Edwards' Diseases of the Rectum, 12 

Cripps' (H.) Cancer of the Rectum, 12 

Diseases of the Rectum and Anus, 12 

Air and Faeces in Urethra, 12 

Cripps" (R. A.) Galenic Pharmacy, 4 
Cuffs Lectures to Nurses, 4 
Cullingworth's Manual of Nursing, 4 

Short Manual for Monthly Nurses, 4 

Dalby's Diseases and Injuries of the Ear, 10 
Short Contributions, 10 

Day on Diseases of Children, 4 

on Headaches. 8 

Domville's Manual frtr Nurses, 4 

Doran's Gynaecological Operations, 3 

Dniitt's Surgeon's vade-Mecum, 8 

Duncan (A.), on Prevention of Disease in Tropics, 5 

Dunglison's Dictionary of Medical Science, 12 

Ellis's (E.) Diseases of Children, 4 

Ellis's (T. S.) Human Foot, 

Fagge's Principles and Practice of Medicine, 6 

Fayrer's Climate and Fevers of India, 5 

Natural History, &c, of Cholera, 5 

Fenwick (E. H.), Electric Illumination of Bladder, n 

Tumours of Urinary Bladder, 11 

Symptoms of Urinary Diseases, n 



Fenwick's (S.) Medical Diagnosis, 6 

Obscure Diseases of the Abdomen, 

Outlines of Medical Treatment, 6 

. Xhe Saliva as a Test, 6 

Fink's Operating for Cataract, 10 

Flower's Diagrams of the Nerves, 1 

Fowler's Dictionary of Practical Medicine, 6 

Fox (Wilson), At las ofPathological Anatomy of Lungs, 6 

Treatise on Diseases of the Lungs, 6 

Frankland and Japp's Inorganic Chemistry, 13 
Fraser's Operations on the Brain, 8 
Fresenius' Qualitative Analysis, 13 

; Quantitative Analysis, 13 

Galabin's Diseases of Women. 3 

Manual of Midwifery, 3 

Gardner's Bleaching, Dyeing, and Calico Printing, 14 

Brewing, Distilling, and Wine Manuf. 14 

Gimlette on Myxcedema, 6 

Glassington's Dental Materia Medica, 10 

Codlee's Atlas of Human Anatomy, 1 

Goodhart's Diseases of Children, 4 

Gowers Diagnosis of Diseases of the Brain, 7 

Manual of Diseases of Nervous System, 

Clinical Lectures, 7 

Medical Ophthalmoscopy, 7 

Syphilis and the Nervous System, 7 

Granville on Gout. 7 

Green's Manual of Botany, 5 

Groves' and Thorp's Chemical Technology, 14 

Guy's Hospital Reports, 7 

Habershon's Diseases of the Abdomen, 7 

Haig's Uric Acid, 6 

Haig-Brown's Elementary Physiology, 2 

Harley on Diseases of the Liver, 7 

Harris's (V. D.) Diseases of Chest, 6 

Harrison's Urinary Organs, 11 

Hartridge's Refraction of the Eye, 10 

- Ophthalmoscope, icj 

Hawthorne's Galenical Preparations of B P , 4 
Heath's Certain Diseases of the Jaws, 8 

Clinical Lectures on Surgical Subjects, 8 

Injuries and Diseases of the Jaws, 8 

Minor Surgery and Bandaging, 8 

Operative Surgery, 8 

Practical Anatomy, 1 

Surgical Diagnosis, 8 

Hellier's Notes on Gynaecological Nursing, 4 
Higgens' Ophthalmic Out-patient Practice, 10 
Hill on Cerebral Circulation, 2 
Hillis' Leprosy in British Guiana, 10 
Hirschfeld's Atlas of Central Nervous System, 2 
Holden's Human Osteology, 1 

Landmarks, 1 

Hooper's Physicians' Vade-Mecum, 5 

Hovell's Diseases of the Ear, 10 

Hyde's Diseases of the Skin, 10 

Hyslop's Mental Physiology, 3 

Impey on Leprosy, 10 

Jacobson's Male Organs of Generation, 12 

Operations of Surgery, 8 

Jellett's Practice of Midwifery, 3 
Jessop's Diseases of the Eye, 9 
Johnson's Asphyxia, 6 

Medical Lectures and Essays, 6 

Cholera Controversy, 6 

Granular Kidney. 6 

Journal of Mental Science. 3 

Keyes' Genito-Urinary Organs and Syphilis, 12 
Kohlrausch's Physical Measurements, 14 
Lancereaux's Atlas of Pathological Anatomy, 2 
Lane's Rheumatic Diseases, 7 

Langdon-Down's Mental AfTections of Childhood, 3 
Lee's Microtomists' Vade Mecum, 14 
Lescher's Recent Materia Medica, 4 
Lewis (Bevan) on the Human Brain, 2 
Liebreich's Atlas of Ophthalmoscopy, 10 
MacMunn's Clinical Chemistry of Urine, 12 
Macnamara's Diseases and Refraction of the Eye, 9 

; ; ; of Bones and Joints, 8 

McNeill's Epidemics and Isolation Hospitals, 2 

Malcolm's Physiology of Death, 9 

Mapother's Papers on Dermatology, 10 

Marcet on Respiration. 2 

Martin's Ambulance Lectures, 8 

Maxwell's Terminologia Medica Polyglotta, 12 

Maylard's Surgery of Alimentary Canal, 9 

[Continued on the nextpaee. 



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Index to J. & A. ChurchuS 



Msyne's Medical Vocabulary, 12 

Mercier's Lunacy Law, 3 

Microscopical Journal, 14 

Mills and Rowan's Fuel and its Applications, 14 

Moore's (N.) Pathological Anatomy of Diseases, 1 

Moore's (Sir W.J.) Family Medicine for India, 5. 

Manual of the Diseases of India, 5 

Tropical Climates, 5 

Morris's Human Anatomy, 1 
Moullin's(Mansell) Surgery, 8 
Nettleship's Diseases of the Eye, 9 
Notter and Firth's Hygiene, 2 
Ogle on Tympanites, 8 
Oliver's Abdominal Tumours, 3 

Diseases of Women, 3 

Ophthalmic (Royal London) Hospital Reports, 9 

Ophthalmologic Society's Transactions, 9 

Ormerod's Diseases of the Nervous System, 7 

Parke*' (E.A.) Practical Hygiene, 2 

Parket' (L.C.) Elements of Health, 2 

Pavy.'s Carbohydrates, 6 

Pereira's Selecta e Prescripts. 4 

Phillips' Materia Medica and Therapeutics, 4 

Pitt-Lewis's Insane and the Law, 3 

Pollock's Histology of the Eye and Eyelids, 9 

Proctor's Practical Pharmacy, 4 

Purcell on Cancer, 11 

Pye-Smith's Diseases of the Skin, n 

Quinby's Notes on Dental Practice, 10 

Ramsay's Elementary Systematic Chemistry, 13 

Inorganic Chemistry, 13 

Reynolds' Diseases of Women, 3 
Richardson's Mechanical Dentistry, 10 
Richmond's Antiseptic Principles for Nurses, 4 
Roberts' (D. Lloyd) Practice of Midwifery, 3 
Robinson's (Tom) Eczema, 11 

Illustrations of Skin Diseases, 11 

Syphilis, 11 

Ross's Aphasia, 7 

Diseases of the Nervous System, 7 

Royle and Harley's Materia Medica, 5 
St. Thomas's Hospital Reports, 7 
Sansom's Valvular Disease of the Heart, 7 
Schweinitz's (G. E. de) Diseases of Eye, to 
Shaw's Diseases of the Eye, 9 
Short Dictionary of Medical Terms, 12 
Silk's Manual of Nitrous Oxide, 10 
Smith's (E.) Clinical Studies, 4 

Diseases in Children, 4 

Wasting Diseases of Infants and Children, 4 

Smith's (J. Greig) Abdominal Surgery, 8 

Smith's (Priestley) Glaucoma, 10 

Snow's Cancer and the Cancer Process, 1 1 

Palliative Treatment of Cancer, n 

Reappearance of Cancer, 11 



Southall's Materia Medica, 5 

Squire's (P.) Companion to the Pharmacopoeia, 4 

Squire's (P.) London Hospitals Pharmacopoeias, 4 

■ Methods and Formula, 14 

Starling's Elements of Human Physiology, 2 
Sternberg's Bacteriology. 6 
Stevenson and Murphy's Hygiene, 2 
Sutton's (H. G.), Lectures on Pathology, 1 
Sutton's (J. B.>, General Pathology, 1 
Sutton's (F.) Volumetric Analysis, 13 
Swain's Surgical Emergencies, 8 
Swayne's Obstetric Aphorisms, 3 
Taylor's (A. S.) Medical Jurisprudence, * 
Taylor's (F.) Practice of Medicine, 6 
Taylor's (J. C), Canary Islands, 8 
Thin's Cancerous Affections of the Skin, 11 

Pathology and Treatment of Ringworm, n 

Thomas's Diseases of Women, 3 
Thompson's (Sir H.) Calculous Disease, ir 

Diseases of the Prostate, 11 

Diseases oftheUrinaryOrgans,n 

Lithotomy and Lithotrity, 11 

Stricture of the Urethra, 11 

Suprapubic Operation, n 

Surgery of theUrinaryOrgans.i 1 

Tumours of the Bladder, n 

Thome's Diseases of the Heart, 7 

Thresh's Water Analysis, 2 

Tilden's Manual of Chemistry, 12 

Tirard's Prescriber's Pharmacopoeia, 5 

Tomes' (C. S.) Dental Anatomy, ro 

Tomes' (J, and C. S.) Dental Surgery, 10 

Tooth's Spinal Cord, 7 

Treves and Lang's German-English Dictionary, 12 

Tuke's Dictionary of Psychological Medicine, 3 

Tuson's Veterinary Pharmacopoeia, 14 

Valentin and Hodgkinson's Qualitative Analysis, 13 

Vintras on the Mineral Waters, &c., of France, 8 

Wagner's Chemical Technology, 13 

Walsham's Surgery : its Theory and Practice, 8 

Waring's Indian Bazaar Medicines, 5 

Practical Therapeutics, 5 

Watts' Organic Chemistry. Ia 

West's (S.) How to Examine the Chest, 6 

Westminster Hospital Reports, 7 

White's (Hale) Materia Medica, Pharmacy, &c, 4 

Wilks' Diseases of the Nervous System, 7 

Williams' Veterinary Medicine, 14 

Surgery, 14 

Wilson's (Sir E.) Anatomists' Vade-Mecum, 1 
Wilson's (G.) Handbook of Hygiene, 2 
Wolfe's Diseases and Injuries of the Eye, 9 
Wynter and Wethered's Practical Pathology, 1 
Year-Book of Pharmacy, 5 
Yeo's (G. F.) Manual of Physiology, 2 



N.B.—f. # A. ChurchilPs larger Catalogue of about 600 works on Anatomy ; 
Physiology, Hygiene, Midwifery, Materia Medica, Medicine, Surgery, Che?nistry, 
Botany, $c. §c, with a complete Index to their Subjects, for easy reference, 
will be forwarded post free on application. 



America. — ■/. 8f A. Churchill being in constant communication with 
various publishing houses in America are able to conduct negotiations 
favourable to English Authors. 



LONDON; 7, GREAT MARLBOROUGH STREET. 



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